Healthcare Provider Details

I. General information

NPI: 1700822764
Provider Name (Legal Business Name): DOROTHY L CALVIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8833 RESEDA BLVD STE D
NORTHRIDGE CA
91324-5356
US

IV. Provider business mailing address

8833 RESEDA BLVD STE D
NORTHRIDGE CA
91324-5356
US

V. Phone/Fax

Practice location:
  • Phone: 818-727-2626
  • Fax: 818-727-2625
Mailing address:
  • Phone: 818-727-2626
  • Fax: 818-727-2625

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0110X
TaxonomyPediatric Ophthalmology and Strabismus Specialist Physician Physician
License NumberG071843
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: